Auto req ID 14261BR
Company (Must match Job Code & Dept first 3 digit#) 336-Argus Health Systems, Inc.
Site Location Kansas City, Missouri
Job Description Pharmacy Benefit Analysts work under the direction of more senior staff in handling basic to moderately complex benefit change requests and research questions. They receive new assignments daily and are assigned the majority of online change requests. As their knowledge level increases, they are assigned more difficult requests that involve multiple benefit changes, code review, benefit design specifications, and coordination with other departments. Pharmacy Benefit Analysts modify and set up benefits based on requirements provided by the customer. They may seek clarification and/or gather additional information from the customer in order to make the change. They consider all the areas that a change may impact in the current benefit setup and determine the most appropriate way to implement the change (e.g., research and look at tables impacted, order of processing, down-stream impacts, unintended consequences). When a benefit change requires a code change, they document basic benefit design specifications, which may be reviewed by a senior team member. Pharmacy Benefit Analysts perform testing and validation to confirm the new benefit setup processes as expected and meets customer requirements and all appropriate forms and documentation are fully and accurately completed. They troubleshoot and perform research on basic to moderately complex claims processing issues or customer inquiries. They may provide input in evaluating how to best set up customer benefits (e.g., different tables, different benefit setup approaches). They are a support resource to the customer while participating as a member of the Benefits team. Direct customer communications tend to be limited to request status or straight forward questions. Pharmacy Benefit Analysts understand how the claims processing, deductible, and authorization systems work; understand claim processing flows; and understand the impact of day-to-day requests.
Required Skills Strong Analytical, System and Computer Skills; Project Management Skills, QC/Testing Skills
Desired Skills Programming Background, Healthcare or Pharmacy
Full or Part Time Full-Time
Travel Requirements Minimal
Working Hours or Shift 1st Shift (Days, M-F, 7am-4pm or 8am-5pm)
